Difference between revisions of "Colorectal adenocarcinoma"

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===Intratumoural lymphocytic response===
===Intratumoural lymphocytic response===
*[[AKA]] '' tumour-infiltrating lymphocytes'', abbreviated ''TILs''.
*[[AKA]] '' tumour-infiltrating lymphocytes'', abbreviated ''TILs''.
 
{{Main|Intratumoural lymphocytic response in colorectal carcinoma}}
====General====
*Finding is suggestive of microsatellite instabillity.<ref name=pmid21114775>{{Cite journal  | last1 = Iacopetta | first1 = B. | last2 = Grieu | first2 = F. | last3 = Amanuel | first3 = B. | title = Microsatellite instability in colorectal cancer. | journal = Asia Pac J Clin Oncol | volume = 6 | issue = 4 | pages = 260-9 | month = Dec | year = 2010 | doi = 10.1111/j.1743-7563.2010.01335.x | PMID = 21114775 }}</ref>
**May be seen in the context of [[Lynch syndrome]].
 
====Microscopic====
Features:
*>10 lymphocytes/0.94 mm<sup>2</sup>.<ref name=pmid12717242>{{Cite journal  | last1 = Greenson | first1 = JK. | last2 = Bonner | first2 = JD. | last3 = Ben-Yzhak | first3 = O. | last4 = Cohen | first4 = HI. | last5 = Miselevich | first5 = I. | last6 = Resnick | first6 = MB. | last7 = Trougouboff | first7 = P. | last8 = Tomsho | first8 = LD. | last9 = Kim | first9 = E. | title = Phenotype of microsatellite unstable colorectal carcinomas: Well-differentiated and focally mucinous tumors and the absence of dirty necrosis correlate with microsatellite instability. | journal = Am J Surg Pathol | volume = 27 | issue = 5 | pages = 563-70 | month = May | year = 2003 | doi =  | PMID = 12717242 }}</ref> †
**Lymphocytes should be between the tumour cells.<ref name=pmid12717242/><ref name=pmid19638537/> ††
***Other lymphocytes do not count.
 
Note:
* † Greenson ''et al.'' says ''>2 lymphocytes/HPF, where 5 HPF are sampled''. Since the sample area given by Greenson ''et al.'' is 0.94 mm<sup>2</sup>, their field diameter is ~ 0.4892 mm. This field diameter corresponds to a 20 mm eye piece (0.4892 mm * 40x = 19.57 mm).
**Many microscopes in use today have a field diameter at 40x of ~ 0.55 mm; thus, 4 fields would be approximately 0.95 mm<sup>2</sup>.
* †† Definitions vary substantially - some authors consider lymphocytes adjacent to the tumour (in the stroma around the tumour cells) "intratumoural".<reF name=pmid9349235>{{Cite journal  | last1 = Ropponen | first1 = KM. | last2 = Eskelinen | first2 = MJ. | last3 = Lipponen | first3 = PK. | last4 = Alhava | first4 = E. | last5 = Kosma | first5 = VM. | title = Prognostic value of tumour-infiltrating lymphocytes (TILs) in colorectal cancer. | journal = J Pathol | volume = 182 | issue = 3 | pages = 318-24 | month = Jul | year = 1997 | doi = 10.1002/(SICI)1096-9896(199707)182:3318::AID-PATH8623.0.CO;2-6 | PMID = 9349235 |URL = http://onlinelibrary.wiley.com/doi/10.1002/%28SICI%291096-9896%28199707%29182:3%3C318::AID-PATH862%3E3.0.CO;2-6/pdf}}</ref>
 
=====Images=====
<gallery>
Image: Tumour-infiltrating lymphocytes - 1 -- high mag.jpg | TILs - high mag. (WC)
Image: Tumour-infiltrating lymphocytes - 1 -- very high mag.jpg | TILS - very high mag. (WC)
Image: Tumour-infiltrating lymphocytes - 2 -- high mag.jpg | TILs - high mag.
Image: Tumour-infiltrating lymphocytes - 2 -- very high mag.jpg | TILs - very high mag.
Image: Tumour-infiltrating lymphocytes - 2 -- extremely high mag.jpg | TILs - extremely high mag.
</gallery>
www:
*[http://jcp.bmjjournals.com/content/62/8/679/F3.large.jpg TILs in endometrial carcinoma (bmjjournals.com)].<ref name=pmid19638537>{{Cite journal  | last1 = Garg | first1 = K. | last2 = Soslow | first2 = RA. | title = Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma. | journal = J Clin Pathol | volume = 62 | issue = 8 | pages = 679-84 | month = Aug | year = 2009 | doi = 10.1136/jcp.2009.064949 | PMID = 19638537 | URL = http://jcp.bmjjournals.com/content/62/8/679.full?related-urls=yes&legid=jclinpath;62/8/679 }}</ref>
*[http://ajcp.ascpjournals.org/content/134/3/478/F2.expansion.html TILs in CRC (ascpjournals.org)].<ref name=pmid20716806>{{Cite journal  | last1 = Ross | first1 = JS. | last2 = Torres-Mora | first2 = J. | last3 = Wagle | first3 = N. | last4 = Jennings | first4 = TA. | last5 = Jones | first5 = DM. | title = Biomarker-based prediction of response to therapy for colorectal cancer: current perspective. | journal = Am J Clin Pathol | volume = 134 | issue = 3 | pages = 478-90 | month = Sep | year = 2010 | doi = 10.1309/AJCP2Y8KTDPOAORH | PMID = 20716806 }}</ref>


===Tumour deposits===
===Tumour deposits===
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